Setting the Record Straight on Medicare for All: An Open Letter From 560 Physicians and Medical Students

Physicians-in-training voice their support for single-payer reform. Photo: Al Nowakowski.

The following statement has been signed by more than 560 physicians and medical students. It was crafted by Andrea Christopher, M.D., Fellow in General Internal Medicine at Harvard Medical School, Adam Gaffney, M.D., Fellow in Pulmonary and Critical Care Medicine at Massachusetts General Hospital and Harvard Medical School, and the two of us, Drs. Steffie Woolhandler and David U. Himmelstein. Other physicians and medical students are invited to read and sign the statement here:

Setting the Record Straight on Medicare for All: An Open Letter From 560 Physicians and Medical Students

The renewed debate over the merits of single-payer health reform has been marred by misleading claims that such reform is unnecessary and unaffordable. We write to set the record straight.

Despite the advances of the Affordable Care Act (ACA), the health care financing system continues to inflict needless suffering on our patients. Nearly 30 million Americans remain uninsured, and co-payments, deductibles and insurers' narrow networks obstruct care for many more. Insurers skim billions from premiums, and impose expensive and time-consuming paperwork on doctors, nurses and hospitals.

Studies in the most trusted journals have quantified the bureaucratic savings achievable through single payer reform. We devote 31 percent of medical spending to administration, vs. 16.7 percent in Canada - a difference of $350 billion annually. And single-payer systems in Canada, the UK and Australia all use their bargaining clout to get discounts of 50 percent from the prices drug companies charge our patients. The potential savings on bureaucracy and drugs are enough to cover the uninsured, and to upgrade coverage for all Americans - a conclusion affirmed over decades by multiple analysts, including the Congressional Budget Office and the Government Accountability Office.

Recent critics of Medicare for All warn of large increases in government spending, but fail to note that these would be fully offset by savings on private insurance premiums and out-of-pocket costs. Their forecasts of massive surges in doctor visits and hospital care conflicts with past experience of coverage expansions. When 15 million Americans gained insurance under the ACA in 2014, hospital admissions didn't budge. No surge in hospital use or doctor visits occurred when Medicare and Medicaid were rolled out, or when Canada's single-payer system started up; doctors saw sick and poor patients more often, but their healthy, wealthy patients a bit less often.

Experience in many nations over many decades provides convincing evidence that single-payer reform is both medically necessary and economically advisable.

In addition to Drs. Gaffney, Himmelstein, Christopher and Woolhandler, this statement has been signed by more than 560 other physicians and medical students.